[Clinical efficacies of different surgical strategies for advanced pancreatic carcinoma].

OBJECTIVE: To explore the clinical efficacies of different surgical strategies for patients with advanced pancreatic carinoma.

METHODS: Retrospective analyses were conducted for the clinical data of 223 advanced pancreatic carinoma patients between January 2009 and December 2013 according to the inclusion criteria. And, according to different surgical strategies, they were divided into seed group (n = 49), radio frequency ablation group (n = 51), radiotherapy group (n = 17) and control group (n = 106). The general data, postoperative complications and follow-up profiles between 4 groups were statistically analyzed.

RESULTS: The general profiles between four groups were not statistically significant (P > 0.05). There was no mortality. The postoperative complication rate was the highest at 43% (21/49) in seed group. However all complications were of Clavien grade II. The follow-up endpoint was until March 2014. The median follow-up period was 7 (1-52) months. The overall follow-up rate was 88.3% (197/223). And their survival rates of one month, half a year, one year and two years were 95.9%, 53.7%, 19.1% and 7.3% respectively. The average survival time was (9.6 ± 0.3) months. In seed group, the rates were 97.7%, 61.9%, 27.7% and 13.2% respectively. The average survival time was (12.9 ± 1.1) months. In radio frequency ablation group, the rates 88.9%, 54.9%, 22.9% and 7.6% respectively. The average survival time was (9.6 ± 0.9) months. In radiotherapy group, the rates were 93.7%, 56.2%, 18.7% and 6.2% respectively. The average survival time was (8.6 ± 1.4) months. In control group, the rates were 97.8%, 48.9%, 13.8% and 5.4% respectively. The average survival time was (8.5 ± 0.5) months. The survival curves of seed, radio frequency ablation and radiotherapy groups were compared separately with that of control group. The Log-rank test results suggested that the survival rate and mean survival time of seed group were higher than those of control group (P < 0.05). However the radio frequency ablation and radiotherapy groups had no significant difference with control group.

CONCLUSIONS: The advanced pancreatic carinoma patients have poor outcomes with a short survival time. The intraoperative implantation of seeds is effective for advanced pancreatic cancer patients, but it also has a high incidence of postoperative complications. Radio frequency ablation and intraoperative radiotherapy fail to effectively prolong the patient survival time.